Topic Contents

Addison's Disease

Topic Overview

What is Addison's disease?

Addison's disease
develops when the
adrenal glands, which are above the kidneys, are not
able to make enough of the
hormones cortisol and, sometimes, aldosterone.

Your body needs both of these hormones to work as it should. Cortisol helps the body cope with extreme physical stress from illness,
injury, surgery, childbirth, or other reasons. Aldosterone helps the body hold
on to the salt it needs, and it keeps your blood pressure steady.

Normally, the level of these hormones increases through a chain reaction. First, the hypothalamus in the brain makes a hormone that the pituitary gland needs to make another hormone called ACTH. ACTH then tells the adrenal glands to make cortisol or aldosterone. But with Addison's disease, the adrenal glands can't make enough of the hormones.

If you have Addison's disease, you need to take medicine for the rest of your life to replace the hormones your body can't make. If you don't treat the disease, an adrenal crisis may occur that can lead to death because of a steep drop in blood pressure.

What causes Addison's disease?

Addison's disease
can occur:

When the body's
immune system kills off the part of the adrenal glands
that makes cortisol and aldosterone. This is the most common cause.

When the adrenal glands
are harmed by:

Infections, such as
tuberculosis,
HIV, and other bacterial or fungal infections.

Cancer that has spread to the adrenal
glands. This is mostly seen in lung cancer.

Bleeding into the
adrenal glands as a side effect of using blood
thinners.

If you have
diabetes, you may have low blood sugar more often, and
it may be more severe than usual.

Symptoms usually start slowly.
You may not even notice them until your body is under extreme stress, such as when a severe
infection, trauma, surgery, or dehydration causes an adrenal crisis. An adrenal
crisis means that your body can't make enough cortisol to cope with the
stress.

In a few cases, Addison's disease gets worse quickly. These
people may already be in an adrenal crisis when they see a doctor.

What happens during an adrenal crisis?

During an adrenal crisis, the body can't make enough cortisol to deal with extreme physical stress. This can cause:

Severe vomiting and
diarrhea.

Sudden pain in the belly, low back, or
legs.

A high fever.

Feeling very weak or
lightheaded.

Feeling restless, confused, or
fearful.

Trouble staying awake.

Call your doctor right away if you have these symptoms. If
an adrenal crisis isn't treated, you could die of
shock from a steep drop in blood pressure.

How is Addison's disease diagnosed?

To diagnose
Addison's disease, the doctor will ask about your health, such as if you have had cancer or have HIV or if you have a family history of Addison's disease. You'll also have a physical exam so the doctor can look for changes in your skin color, check your blood pressure, and look for signs of dehydration.

Your doctor may also order tests, such as:

Blood tests to check for high
potassium or low sodium levels. Your cortisol and
ACTH levels may be checked too.

ACTH
stimulation test to see how your hormone levels react to stress.

Imaging tests, such as a CT scan or an
MRI, to look for damage to the adrenal glands.

How is it treated?

Treatment includes medicine, self-care, and being prepared for when your body is under stress. If your doctor thinks that you have Addison's disease, he or she may
start treatment right away, even before you get your test results.

Take your medicine as prescribed. You will need to take medicine for the rest of your life to replace the
cortisol and aldosterone your body can't make on its own. You may take just one
medicine, or you may need more than one.

Take care of yourself at home. You may need to:

Get enough salt in your diet, because your body may lose too much. You may need to add extra salt to your food during hot and humid weather
or when you are exercising and sweating.

Weigh yourself regularly, especially if you haven't felt like eating or you have been vomiting.

Monitor your
blood pressure.
Let your doctor know if it's high or too low and causing you to feel lightheaded.

Be prepared for times when your body is under stress. Here are a few ways you can prepare:

Have a shot of emergency
medicine with you at all times. Know when and how
to give the medicine. Have instructions written out, and teach someone else how
to give you the medicine in case you can't give it to yourself.

Wear a medical ID tag (such as a
medical alert bracelet). That way, health professionals know to give you a shot
of cortisol if you are injured or ill and cannot speak for
yourself.

Work with your doctor to create a plan for what to do when you're sick or when your body is under stress.

Finding out that you have Addison's disease can be scary. But if you get treatment and follow your doctor's advice, you can lead a long and healthy life.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.
How this information was developed to help you make better health decisions.